About Our Company
At Altais, we’re looking for bold and curious clinicians and innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.
About Your Team
Are you looking to work with a high performing, fast growing and dynamic Delegation Oversight team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.
About Your Work
As a Program Specialist I in Delegation Oversight, you will ensure accurate and timely regulatory submissions and manage tracking logs for health plans. Your key responsibilities will include delivering detailed reports, managing regulatory submissions, audits, and compliance processes, driving workflow improvements, and ensuring legal standards are met. You will coordinate seamlessly with health plans and internal departments to enhance clinical performance and patient access, run and manage weekly, monthly, and quarterly reports, and maintain and update clinical performance policies. Additionally, you will coordinate audits with health plan partners, ensure legal compliance, oversee partner requests, manage corrective action plans, support organizational projects and vendor management, and provide timely updates and reports to leadership. Our Delegation Oversight team excels in generating precise reports, managing health information exchanges, ensuring regulatory compliance, and optimizing workflows. We conduct regular audits, oversee partner requests, and maintain high standards of patient access and vendor management. We seek individuals with a strong commitment to patient-centered care and a passion for promoting health and wellness.
You Will Focus On:
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Run weekly, monthly, and quarterly reports as required in timely manner and in specific formats depending on plan.
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Create generic report templates and manage required logs and reporting process with health plans and those departments responsible for Brown & Toland’s health information exchange.
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Maintain policies and procedures related to clinical performance and assist in update of regulatory processes.
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Recommend and implementing workflow improvements.
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Ensure organization complying to legal and federal regulations.
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Coordinate monthly, quarterly, and annual audits with Health Plan partners.
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Provide all required documents and reports requested by Health Plan partners.
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Oversee all contracted partners request are implemented and live (ex; Logo, Letters, requirements, etc.)
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Compile and deliver Clinical Services current state, reports, and updates to Leadership for Quarterly meetings.
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Manage all external and internal reports for Utilization Management, Quality, Inpatient, Outpatient Care Management.
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Prevent, manage, and respond to Correction Action plans.
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Track and trend correction action plans.
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Ensure Patient Access Standards (DMHC) are met.
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Conduct and report Patient Access to Care conducting mystery shopper on a quarterly basis.
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Educate providers contractual obligation on patient access.
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Coordinate with internal departments on organization projects.
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Vendor Management
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Create, implement, and maintain policies and procedures within BT organization.
The Skills, Experience & Education You Bring
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Strong technical skills, detail oriented and ability to use multiple platforms and systems seamlessly.
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Highly organized and capable of turning out high quality deliverables quickly and consistently while dealing with competing deadlines.
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Strong communication and customer service skills in both verbal and written format.
You Share our Mission & Values
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You are passionate about improving the healthcare experience and want to be part of the Altais mission.
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You are bold and curious – willing to take risks, try new things and be creative.
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You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
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You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
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You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
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You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.
Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.
The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, experience, and geographic location. This base pay range is specific to California and can vary based on Bay Area, Metro LA, and Greater California regions which may not be applicable to other locations.
Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.
Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork – Activity level: Sedentary, frequency most of workday.
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.